[Cystocele]

A cystocele is a bladder hernia through the anterior wall of the vagina. It is common in elderly women. There is no clinico-anatomical correlation, but the functional disturbance, although both variable and variably experienced, remains a major factor in the indication of eventual surgery. Methodologic clinical examination should be made to seek anomalies of pelvic stasis associated with a more or less hidden urinary incontinence. The surgical technique should be chosen according to the age and the classification of the patient, determined by complementary examinations that range from simple to highly technical (echography, cystography and sometimes study of urinary dynamics and MRI). The surgeon should chose the technique of perineal support and clearly explain the possibility of failure or recurrence. Confidence between the patient and the surgeon remains the best guarantee of a good result of management. Such surgery can be proposed to women to request it for physical comfort, whereas the surgeon should be very cautious with regard to those who do not want to undergo surgery (but also with those who strongly insist on surgery).